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Published on: November 10, 2015
Updating estimates of Plasmodium knowlesi malaria risk in response to changing land use patterns across Southeast
Ruarai J Tobin1, Lucinda E Harrison2, Meg K Tully1
1Infectious Disease Dynamics Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
Background:
Plasmodium knowlesi is a zoonotic parasite that causes malaria in humans. The pathogen has a natural host reservoir in certain macaque species and is transmitted to humans via mosquitoes of the Anopheles Leucosphyrus Group. The risk of human P. knowlesi infection varies across Southeast Asia and is dependent upon environmental factors. Understanding this geographic variation in risk is important both for enabling appropriate diagnosis and treatment of the disease and for improving the planning and evaluation of malaria elimination. However, the data available on P. knowlesi occurrence are biased towards regions with greater surveillance and sampling effort. Predicting the spatial variation in risk of P. knowlesi malaria requires methods that can both incorporate environmental risk factors and account for spatial bias in detection.
Methods & Results:
We extend and apply an environmental niche modelling framework as implemented by a previous mapping study of P. knowlesi transmission risk which included data up to 2015. We reviewed the literature from October 2015 through to March 2020 and identified 264 new records of P. knowlesi, with a total of 524 occurrences included in the current study following consolidation with the 2015 study. The modelling framework used in the 2015 study was extended, with changes including the addition of new covariates to capture the effect of deforestation and urbanisation on P. knowlesi transmission.
Discussion:
Our map of P. knowlesi relative transmission suitability estimates that the risk posed by the pathogen is highest in Malaysia and Indonesia, with localised areas of high risk also predicted in the Greater Mekong Subregion, The Philippines and Northeast India. These results highlight areas of priority for P. knowlesi surveillance and prospective sampling to address the challenge the disease poses to malaria elimination planning.
Insights
Plasmodium knowlesi malaria risk is highest in Malaysia and Indonesia, with localized high-risk areas in Southeast Asia. This study maps transmission suitability to guide malaria elimination efforts.
Area of Science:
- Zoonotic disease epidemiology
- Spatial ecology of infectious diseases
- Malaria elimination strategies
Background:
- Plasmodium knowlesi is a zoonotic parasite causing human malaria, transmitted by Anopheles mosquitoes from macaque reservoirs.
- Geographic risk of P. knowlesi infection varies due to environmental factors, complicating diagnosis, treatment, and elimination planning.
- Existing P. knowlesi occurrence data are biased by surveillance efforts, necessitating methods that account for environmental factors and detection biases.
Approach:
- An environmental niche modeling framework was extended and applied, incorporating data up to March 2020.
- 264 new P. knowlesi records were identified, consolidating with previous data for a total of 524 occurrences.
- New covariates, including deforestation and urbanization, were added to model P. knowlesi transmission dynamics.
Key Points:
- The updated model predicts the highest P. knowlesi transmission suitability in Malaysia and Indonesia.
- Localized areas of high risk were also identified in the Greater Mekong Subregion, The Philippines, and Northeast India.
- These predictions are crucial for prioritizing P. knowlesi surveillance and sampling.
Conclusions:
- The study provides a refined map of P. knowlesi relative transmission suitability.
- Identified high-risk areas are critical for targeted interventions in malaria elimination programs.
- Addressing P. knowlesi transmission is essential for achieving malaria-free goals in endemic regions.
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